¹²³I-Iomazenil (IMZ) SPECTによる脳外傷後高次脳機能障害の神経画像

• 中川原 譲二

  中村記念病院 脳神経外科

• 上山 憲司

  中村記念病院 脳神経外科

• 高橋 正昭

  中村記念病院 放射線部

• 中村 博彦

  中村記念病院 脳神経外科

書誌事項

タイトル別名

• Neuroimaging of post-traumatic higher brain dysfunction using ¹²³I-Iomazenil (IMZ) SPECT

抄録

In patients with mild traumatic brain injury (MTBI), higher brain dysfunctions which consist of cognitive impairments such as memory, attention, performance and social behavioral disturbances could be rarely apparent. However, higher brain dysfunctions should be identified by neuropsychological tests and supported by a social welfare for handicapped patients. Acknowledgement of higher brain dysfunctions after MTBI without obvious brain damages on morphological neuroimagings could be a social issue under controversy. An imaging of cortical neuron damages in patients with higher brain dysfunctions after MTBI was studied by functional neuroimaging using ¹²³I-Iomazenil (IMZ) SPECT. Statistical imaging analyses using 3 dimensional stereotactic surface projections (3D-SSP) for ¹²³I-IMZ SPECT and ¹²³I-IMP SPECT as CBF studies were performed in 11 patients with higher brain dysfunctions after MTBI. In all patients with higher brain dysfunctions defined by neuropsychological tests, cortical neuron damages were observed in bilateral medial frontal lobes, but reduction of CBF in bilateral medial frontal lobes were less obviously showed in 8 patients (apparent in 3 and little in 5). Group comparison of 3D-SSP of ¹²³I-IMZ SPECT between 11 patients and 18 normal controls demonstrated significant selective loss of cortical neuron in bilateral medial frontal gyrus (MFG). Extent of abnormal pixels on each cortical gyrus using stereotactic extraction estimation (SEE) for 3D-SSP of ¹²³I-IMZ SPECT confirmed that 8 patients had abnormal pixel extent >10% in bilateral MFG and 5 patients had abnormal pixel extent >10% in bilateral anterior cingulate gyrus. In patients with MTBI, higher brain dysfunctions seems to correlate with selective loss of cortical neuron within bilateral MFG which could be caused by Wallerian degeneration as secondary phenomena after diffuse axonal injury within corpus callosum. Statistical imaging analysis using 3D-SSP for ¹²³I-IMZ SPECT could be valuable for diagnosis of higher brain dysfunctions without obvious brain damages on morphological neuroimagings in patients with MTBI.

収録刊行物

• 神経外傷

  神経外傷 33 (2), 165-172, 2010-12-27

  一般社団法人 日本脳神経外傷学会

キーワード

• Mild traumatic brain injury
• Post-traumatic higher brain dysfunction
• ¹²³I-Iomazenil (IMZ)
• SPECT
• 3D-SSP

詳細情報

• CRID: 1390287750914071936
• NII論文ID: 10031136415
• NII書誌ID: AN00358577
• DOI: 10.32187/neurotraumatology.33.2_165
• ISSN: 24343900
• Web Site: https://search.jamas.or.jp/link/ui/2011242557
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可